Tetracycline resistance is frequent among Campylobacter jejuni isolates from Kuwait

Campylobacter jejuni is a major cause of diarrhea worldwide, including Kuwait. Kuwait is an important destination for commerce, employment for expatriates, and stationing of multinational troops. Knowledge about antimicrobial susceptibility of C. jejuni will be helpful for empirical treatment of infection. Tetracycline is one of the antibiotics recommended for treatment, but no data exist for tetracycline resistance in C. jejuni for the Arabian Gulf region. We characterized the tetracycline susceptibility of 85 C. jejuni isolates from diarrheal stools of patients seen at a teaching hospital in Kuwait during 2003-2006. Thirty-four (40%) isolates were tetracycline resistant (minimum inhibitory concentration >or=16 microg/ml), with 30 isolates carrying the tet(O) gene, including 19 isolates that carried the gene on a 35 kb plasmid. Four selected tetracycline-resistant donor strains transferred the plasmids and tetracycline resistances to a tetracycline-susceptible C. jejuni strain on conjugation. Tetracycline-resistant C. jejuni isolates were genetically unrelated to each other by pulsed-field gel electrophoresis. Thus, tetracycline resistance is common in C. jejuni isolates from Kuwait with the resistance determinant carried on transmissible plasmids. We conclude that tetracycline resistance is a feature of C. jejuni in Kuwait as in other parts of the world and that empirical therapy with tetracycline will yield variable results in Kuwait.